Shane  A  Wear    MD
Contract Details
Radiology Associates of Birmingham
Facility name
Provider ID
P000007360
NPI
1457497851
Tax ID
630574300
Effective Date
6/7/2001
Last Updated
7/23/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
2204 Lakeshore Drive Suite 140
Birmingham, AL 35209
United States
County
Jefferson
Phone
2058248000 (Phone)
Billing Details
Address
2204 Lakeshore Drive
Suite 140
Birmingham, AL 35209
Billing Phone
2058248000
Specialty Type
Radiology, Diagnostic
Map
Address